How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $645.65 Median $1,584.89 Typical High $5,248.07 | Facility | None | $645.65 | $1,584.89 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $645.65 Typical High $1,584.89 | Professional | None | $436.52 | $645.65 | $1,584.89 |
CareFirst Setting Professional Modifier None Typical Low $416.87 Median $467.74 Typical High $2,630.27 | Professional | None | $416.87 | $467.74 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $602.56 Typical High $1,737.80 | Professional | None | $398.11 | $602.56 | $1,737.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $1,000.00 Typical High $1,445.44 | Professional | None | $676.08 | $1,000.00 | $1,445.44 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $5,754.40 Typical High $27,542.29 | Facility | None | $1,288.25 | $5,754.40 | $27,542.29 |
United Setting Professional Modifier None Typical Low $380.19 Median $724.44 Typical High $1,548.82 | Professional | None | $380.19 | $724.44 | $1,548.82 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $213.80 Median $269.15 Typical High $323.59 | Professional | 52 · Reduced service | $213.80 | $269.15 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $107.15 Typical High $128.82 | Professional | 53 · Discontinued | $85.11 | $107.15 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $407.38 Typical High $478.63 | Professional | 54 · Surgery only | $316.23 | $407.38 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $81.28 Typical High $95.50 | Professional | 55 · Aftercare only | $63.10 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $53.70 Typical High $64.57 | Professional | 56 · Pre-op care only | $42.66 | $53.70 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $380.19 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $295.12 | $380.19 | $446.68 |
Where Washington, DC sits
The same service costs 4.9 times more in Alaska than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Washington, DC· 28th of 51
$646
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.